February 4, 2022
7 min. read

Depression: Diagnosis, Treatment, and Support

Medly

If you are in acute emotional distress or are having thoughts of suicide, call the National Suicide Prevention Lifeline at 800-273-8255. 

What is depression? 

Depression, also known as major depressive disorder or clinical depression, is a mood disorder that causes persistent feelings of sadness and loss of interest. Depression affects how you feel, think, and behave, and can lead to a variety of emotional and physical problems. While passing feelings of sadness may not require treatment, patients experiencing depression will exhibit symptoms severe and consistent enough to disrupt their behavior and participation in day-to-day activities. 

If you are experiencing symptoms of depression, just know that you’re not alone—depression affects more than 16.1 million American adults, or about 6.7% of the U.S. population, in a given year.

depression symptoms

What are some signs and symptoms of depression? 

Depression may occur once during your life, but it is more common to have multiple depressive episodes. During these episodes, the following symptoms usually occur most every day, all day long: 

  • Feelings of sadness, tearfulness, emptiness or hopelessness
  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so even small tasks take extra effort
  • Reduced appetite and weight loss or increased cravings for food and weight gain
  • Anxiety, agitation or restlessness
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or self-blame
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches

How is depression diagnosed? 

There are about four different ways that your provider may diagnose you with depression, including: 

  • A physical exam. This will include general questions about your health. This is done because in some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. These tests may include a blood test called a complete blood count, or a lab test to check your thyroid to make sure it’s functioning properly.
  • Psychiatric evaluation. During a psychiatric evaluation, your mental health professional will ask you about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
  • The DSM-5. The DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, lists the criteria for a diagnosis of depression. Your doctor may use this when speaking with you to provide you with a diagnosis. 

depression treatment

How is depression treated? 

Depression is usually treated with a combination of psychotherapy and medication. 

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. In psychotherapy, also known as talk therapy or psychological therapy, patients talk about their condition and related issues with a mental health professional. There are different types of psychotherapy available to help treat depression, including cognitive behavioral therapy, or CBT, and interpersonal therapy

If you are interested in medication treatment, you’ll need to work with a psychiatrist. Depending on your evaluation, you may be prescribed one of the following medications: 

  • Selective serotonin reuptake inhibitors (SSRIs) (Citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd)): Doctors often begin treating depression with an SSRI, as they are considered safer than alternative drug therapies, and generally cause fewer side effects than other types of antidepressants. 
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs) Duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima)): These medications are a class of antidepressant drugs that treat major depressive disorder. 
  • Atypical antidepressants (bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix)): Atypical antidepressants are medications that don’t fit neatly into any of the other antidepressant categories. 
  • Tricyclic antidepressants (Imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil)): Tricyclic antidepressants are effective in treating depression, but tend to cause more severe side effects than other, newer antidepressants. For this reason, they generally aren’t prescribed unless you’ve already failed to improve with an SSRI. 
  • Monoamine oxidase inhibitors (MAOIs) (Tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan)): Monoamine oxidase inhibitors are typically prescribed as a second line of treatment, as other antidepressants may be safer or cause fewer side effects, and they can’t be combined with SSRIs. Those taking MAOIs should follow a strict diet to avoid interactions with foods like certain cheeses, pickles, wines, some medications, and herbal supplements. There is a newer MAOI that sticks on the skin as a patch, called Selegiline (Emsam), that may cause fewer side effects than other MAOIs. Make sure to discuss your eating and drinking habits with your doctor if you’re taking this medication. 
  • Other medications. Other medications may be added to an antidepressant to enhance its effects. For example, you might take a mood stabilizer or antipsychotic along with your antidepressant. Anti-anxiety and stimulant medications may also be added for short-term use. 

depression signs

What are some tips for helping me find the right medication? 

Finding the right medication may require a bit of trial and error in partnership with your physician. Some patients will need to try several medications, or a combination of medications, before finding a treatment that works. Some medications take up to several weeks or longer to take full effect and for your body to adjust, so medication adherence is important for best results. In some cases, if you know that a family member has responded well to a certain antidepressant, it can help to bring that information to your prescribing physician. 

What are the risks of stopping my medication abruptly? 

It’s not advised to stop taking an antidepressant without talking to your doctor first. While antidepressants aren’t considered addictive, it is possible to develop a physical dependence on the drugs. Missing several doses or stopping treatment abruptly can cause withdrawal-like symptoms or cause a sudden worsening of depression. If you are interested in going off an antidepressant, work with your doctor to gradually and safely decrease your dose. 

If you are struggling with symptoms of depression, there is help available. In fact, with proper diagnosis and treatment, the vast majority of people with depression will overcome it. If you are experiencing symptoms of depression, the first step is to see your family physician or psychiatrist. Talk about your concerns and request a thorough evaluation. 

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